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1306960950
BRENDA LEE PROVENCHER
AUBURNDALE, MA
NPI
1306960950
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MA 8920)
Enumeration Date
2007-03-19
Last Update Date
2007-07-08
Business Address
-- BRENDA LEE PROVENCHER OTR
120 SEMINARY AVE
AUBURNDALE, MA 02466-2650
Phone number: 617-663-7023
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Mailing Address
-- BRENDA LEE PROVENCHER OTR
77 BUNKERHILL PKWY
WEST BOYLSTON, MA 01583-2022
Phone number: 508-835-4571
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